Phylum: Proteobacteria

Class: Gammaproteobacteria

Order: Vibionales

Family: Vibrionaceae

Genus: Vibrio

Species: cholerae

Spreading/transmission may occur when poor hygiene and/or sanitation is involved.

• drinking contaminated water

• consuming rice that has been watered with contaminated water

• consuming produce that has been washed in contaminated water

• eating raw or undercooked seafood (shellfish such as shrimp & crab)

• direct contact with an infected individual's feces or vomit

Note that it is unlikely to spread cholera via casual contact with an infected person

• watery diarrhea that is often described as "rice-water stools"

• vomiting

• leg cramping

• restlessness/irritability

Later and more severe symptoms include

• rapid heart rate

• loss of elasticity of the skin

• dry mucous membranes

• low blood pressure

If left untreated these symptoms can lead to severe dehydration which can lead to kidney failure, shock, coma, and even death.

More concerning is the long-term effects on infants and young children of whom suffer in term of stunted growth, particularly in height.

Both Dukora and Voxchora are used/recommended for travelers if they are planning to travel to countries where cholera is known to be present or where the water might be unsafe to drink/use. Voxchora is the only FDA vaccine approved for use in the US.

Cholera vaccines work because they contain a weakened or dead form of the bacteria thus triggering the production of antibodies and an immune response without causing the disease. The immune response happens in the intestine where cholerae normally attaches to the intestinal walls and colonizes the gut.

It should be noted that OCVs are not 100% effective and do not protect against all strains of V. cholerae.

• Rehydration therapy to replace fluids lost due to diarrhea and vomiting. Ex. Drinking oral rehydration solutions that contain salts and minerals, intravenous fluids, and electrolytes.

• Antibiotics can be used for patients that are severely ill depending on the length of time that they have been sick. Antibiotics are to be used in conjunction with frequent/continuous rehydration.

  
  

  Treatment for children under the age of 5 it is common to include Zinc supplementation regardless of the severity of dehydration because it reduces the duration and volume of diarrhea.

* In 2017 and 2019, Yemen accounted for 84% and 93% of all cholera cases respectively (Weekly Epidemiological Report 2018, 2020).